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INDONESIA
Majalah Anestesia dan Critical Care
Published by Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif Indonesia
ISSN : -     EISSN : 25027999     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Majalah ANESTESIA & CRITICAL CARE (The Indonesian Journal of Anesthesiology and Critical Care) is to publish peer-reviewed original articles in clinical research relevant to anesthesia, critical care, and case report . This journal is published every 4 months (February, June, and October) by Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif Indonesia (PERDATIN).
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Articles 8 Documents
 1 
Search results for , issue " Vol 33 No 1 (2015): Februari" : 8 Documents clear
Blood Rheology and It’s Effect in Various Clinical Conditio Rahardjo, Theresia Monica; Wargahadibrata, Himendra
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
Publisher : Perdatin Pusat

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Abstract

Blood ia a heterogen fluid consists of a suspension of blood cells, erythrocyte, leucocyte, thrombocyte, in a liquid plasma which contains water, proteins, mineral ions, hormones and glucose. Blood rheology is well known has an important rule in circulation. Blood viscosity depend on shear forces and determined by hematocrit, plasma viscocity, blood cells distribution and mechanical properties. Blood rheology can be altered in various pathology proccess like diorder of hematocrit, erytrocute deformability and aggregation. Hematocrit alteration contributed significantly to hemorheology variation and extreme physiologist conditions. Erytrocyte deformability sensitive to local and general homeostasis caused by endogen or exogen factors. Erythrocyte aggregation is determined by plasma protein composition and erythrocyte surface properties like acute phase of inflammation, other factors are in vivo aging, free radical and proteolitic enzymes. Rheology alteration will cause impairment of blood fluidity which is significantly affect tissue perfusion and result in organ function deteriorations, especially if disease processes also disturb vascular properties. This review will reveal blood rheology effect on various pathological conditions, like sepsis, hypertension and diabetes mellitus.
Comparison of Agitation Incidence in Adult Ambulatory Patients who Underwent Surgery by General Anesthesia Using Desflurane or Sevoflurane Putri, Andika C.; Nawawi, A. Muthalib; Bisri, Tatang
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
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Abstract

Postanesthesia agitation is a problem that sometimes occurs in patients who underwent general anesthesia. Thisstudy aims to compare the magnitude of the incident postanesthesia agitationin patienambulatory surgery performedunder general anesthesia with desflurane or sevoflurane use. Research single blinde randomized controlled trial in94 ambulatory surgical patients ASA I. Subjects divided into two groups: group I received desfluran and group IIreceived sevoflurane. Both groups at induction with propofol 2 mg/kg, fentanyl 2 μg/kgBW, atrakurium 0,1 mg/kg, then do laringeal mask airway (LMA) installation. Agitation in patiens assesed since the LMA is removed,the use of anesthetic drugs has beeb stoped, then at minute 5, 10, 15, 20, 25, 30, every five minutes after usingagitation-sedation scale riker. Statistic analysis using Chi-square and Mann-Whitney Test. The results obtainedindicate that the ratio of the incidence of agitation in the recovery room between the desflurane with sevofluranegroups were not statistically significant. Obtained 7 patients experiencing agitation pascaanestesi desflurane groupof 47 samples (14.9%), whereas only 5 patients with agitation of 47 samples sevoflurane group (10.6%). Onepatient from group desflurane assessed his agitation scale 6 (very agitated). The result of comparative magnitudeof the incidence of agitation in the group performed under general anesthesia using desflurance with sevofluranegroup using there is not a statistically significant difference.
Sensitivity and Specificity of Neutrophil Gelatinase Associated Lipocalin as an Early Biomarker or Acute Kidney Injury Andriani, Meili; , Zulkifli; Puspita, Yusni; , Theodorus
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
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Abstract

in hospital. Incidence of AKI is about 60%–70% and mortality rate from those patients is 60%. AKI is diagnosed by measuring serum creatinine concentration, which is an unreliable and delayed marker of deterioration of kidney function. It’s rising occurs when a significant amount of renal function has lost. Neutrophil gelatinase associated lipocalin (NGAL) level in AKI patients can increase quickly and earlier compared to serum creatinine and could be as a marker for AKI. The purpose of this study was to assess the sensitivity and specificity plasma NGAL. A diagnostic test was conducted in ICU and high care unit (HCU) of RS Dr. Moh. Hoesin Palembang since December 2014 to February 2015. There were 53 subjects included. All samples were examined with Alere Triage® kit and serum creatinin. Data analysis were performed by receiver operating characteristic (ROC) using SPSS® version 22.0.and MedCalc version 12.7. This study shows that a cut-off point 150 ng/mL for plasma NGAL has sensitivity of 88%, specificity of 81%, positive predictive value of 88%, negative predictive value of 81% and accuracy of 85%. Examination of plasma NGAL is more sensitive and specific in determining the start time of the occurrence of AKI compared with serum creatinine examination.
Tracheal Stenosis due to Trachesotomy Attaufany, Fahmi; Dewi, Yussy Afriani; Samiadi, Dindi; Permana, Agung Dinasti; Aroeman, Nurakbar
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
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Abstract

Tracheal stenosis is a condition where there is a narrowing of the diameter of the trachea. This condition can occurin congenital or acquired. Approximately 90% due to trauma: internal (prolonged intubation, tracheostomy, etc)with remaining due to external trauma (blunt trauma or penetrating trauma).The incidence of tracheal stenosisapproximately 4%–13% in adults and 1%–8% in neonates. The incidence of tracheal stenosis in Dept ORL-HNSDr. Hasan Sadikin General Hospital Bandung from January 2012–August 2013 as much as ive cases. We presenteda a man, 27 years old, suffer with complain of dyspnea. We found tracheal stenosis grade II (Myer-Cotton) afterlexible bronchoscopic examination due to previous tracheostomy.Tracheostomy was perform followed byinstallation tracheal tube and observation. Two years later the tracheal tube removed and continued with stomalclosure.
Effect of Vitamin C 1.000 mg Intravenous Therapy to Lactate Level, Base Deficit and Central Vein Saturation (SvO2) in Septic Patient Rahardjo,, Theresia Monica; Redjeki, Ike Sri; Kurniadi, Rudi
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
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Abstract

Microvascular endothelial dysfunction is a major problem in sepsis patient, followed by a very high morbidity and mortality rate even optimal effort was done. Vitamin C has ability as antioxidant and can improve endothelial cell function. A prospective, randomized, placebo-controlled, and double blind study was conducted at Intensive Care Unit (ICU) Dr. Hasan Sadikin General Hospital Bandung within 6 months to evaluate the effect of vitamin C 1.000 mg intravenous on lactate level, base deficit and SvO2, in 33 septic patients, aged 17–60 years with acute physiology and chronic health evaluation II (APACHE II) score 15–23. Subjects were divided into two groups, treatment group was given an injection of 5 mL vitamin C 1000 mg and control group had a 5 mL NaCl 0.9% at first to seventh day. Measurement of lactate level, base deficit and SvO2 was done at day 1, day 3, day 5, and day 7. Result showed a significant different lactate level between two groups, a very significant decrease of lactate level and decrease of lactate level percentage occurred in treatment group at day 5. and 7 (p<0.001), a significant decrease of base deficit (p<0.002) and an unsignificant decrease of SvO2 (p>0.05). In conclusion, vitamin C 1.000 mg intravenous can improve lactate level, base deficit and SvO2 in septic patient.
Duration of Analgesia and Blood Pressure by Giving Midazolam 2 mg Compared to Fentanyl 25 mcg in Hyperbaric Bupivacaine 10 mg During Cesarean Delivery Sitanggang, Ruli Herman; Harniati, Siti; Redjeki, Ike Sri
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
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Abstract

Pain free episode after Cesarean deliveryis needed by the mother to take care the baby. Opioid is the most common adjuvant used in spinal anesthesia, but still has unpleasant side effects, while Midazolam 2 mg is known to prolong analgesia. This study was using randomized double-blind experimental design. The subject of this study is 40 pregnant women with ASA II who underwent Cesarean delivery with spinal anesthesia. Research subjects are divided into 2 groups of study. The first group was given a combination of Fentanyl 25 mcg + 0.5% Bupivacaine 10 mg (BF) while the second group was given Midazolam 2mg+0,5% Bupivacaine 10 mg (BM). The duration of analgesia in 2 groups was assessed using a numeric rating scale (NRS). Then the data were analyzed using T-test, Mann Whitney test and Chi square test. The results showed no significant difference in both groups in a decrease of systolic blood pressure (p>0.05). Duration of analgesia in Midazolam group is 217.5 (39.32) minutes longer than Fentanyl group 124.0 (10.83) minutes. The conclusion is additional Midazolam 2 mg may prolong analgesia compared with Fentanyl 25 mcg without a decrease in blood pressure in Caserean delivery.
Respiratory Failure due to Transfusion Related Acute Lung Injury (TRALI) and Atelectasis and Acute Kidney Injury Post Cardiac Surgery: A Case Report wullur, caroline; Sitanggang, Ruli Herman
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
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Abstract

Postoperative pulmonary complications and acute kidney injuries are the most frequent and significant contributor to morbidity, mortality and costs associated with hospitalization. Despite the prevalance of these complications in cardiac surgery patients, recognition, diagnosis and management of this problem vary widely. Many factors may contribute to the pathogenesis of lung complications include atelectasis, Transfusion Related Acute Lung Injury (TRALI) and Acute Respiratory Distress Syndrome (ARDS). While haemodynamic, inflammatory and nephrotic factors are involved and overlap each other in leading to kidney injury. A 54-year-old patient with history of hypertension and diabetes melitus underwent coronary artery bypass graft. On postoperative day 1, he had worsening respiratory and renal function with suspected atelectasis and TRALI. Alveolar lung recruitment maneuvers as well as Sustained Low-Efficiency Dialysis (SLED) were conducted. He was transferred to regular ward on postoperative day seven and discharged uneventfully two days later. Early recognition and management including alveolar recruitment maneuvers and dialysis have an important role in the prevention and treatment of these complications.
Fluid Management in Pediatric Craniotomy Fuadi, Iwan; Pison, Osmond Muvtilof; Redjeki, Ike Sri
Majalah Anestesia dan Critical Care Vol 33 No 1 (2015): Februari
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Abstract

Advances in pediatric neurosurgery techniques have dramatically improved the outcome in infants and children with surgical lesions of the central nervous system. However, the physiologic and developmental differences inherent in pediatric patients present challenges to neurosurgeons and anesthesiologists alike. Fluid management is critically important in pediatric craniotomy. Hemodynamic stability during intracranial surgery requires the careful maintenance of intravascular volume and electrolytes. It is imperative to secure excellent intravenous access for fluid and blood replacement and drug delivery before the start of the operation. Lack of intake or active vomiting because of changes in the ICP, preoperative fluid restriction and diuretic therapy may lead to blood pressure instability and even cardiovascular collapse if sudden blood loss occurs. Normovolemia should be maintained throughout the procedure. Normal saline used as the maintenance fluid during neurosurgery because it’s mildly hyperosmolar and should minimize cerebral edema. Maintenance rate of fluid administration depends on the weight of the patient. The maximum allowable blood loss should be determined in advance. Hyperglycemia is always best avoided because it may exacerbate neurologic injury. Fluid management in neurosurgical cases is extremely important and requires good communication between the surgeon and anesthesiologist. Especially for infants and children because of the difference in the anatomy and physiology at various stages of growth and development. The anesthesiologist must be fully cognizant of these differences in order to conduct a safe anesthetic plan.

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